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Preterm birth time trends in Europe: a study of 19 countries
J Zeitlin1, K Szamotulska, N Drewniak
1INSERM, UMRS 953, Epidemiological Research Unit on Perinatal and Women's and Children's Health, Paris, France; UPMC, Paris, France.
Summary
Preterm birth rates in Europe varied significantly, with many countries maintaining or reducing singleton preterm births. These trends challenge the notion of universally rising rates, highlighting the need to understand country-specific differences for prevention strategies.
Area of Science:
- Reproductive Health
- Perinatal Epidemiology
- Public Health Policy
Background:
- Preterm birth remains a significant global health concern, with complex contributing factors.
- Understanding temporal trends is crucial for effective public health interventions.
- Existing data suggest rising preterm birth rates in many regions, but country-specific variations require detailed investigation.
Purpose of the Study:
- To analyze time trends in preterm birth rates across 19 European countries.
- To examine these trends by birth multiplicity, gestational age, and mode of delivery onset.
- To identify variations in preterm birth trends within Europe.
Main Methods:
- Utilized aggregate data from routine sources for live births in 1996, 2000, 2004, and 2008.
- Employed log-binomial regression models to estimate annual risk ratios of preterm birth.
- Analyzed overall rates and rates stratified by multiplicity, gestational age, and spontaneous vs. non-spontaneous onset.
Main Results:
- Preterm birth rates increased in most European countries, but with considerable variation in magnitude.
- Rising multiple birth rates and preterm birth rates in multiple births contributed to overall increases.
- Approximately half of the countries showed no change or a decrease in singleton preterm birth rates.
- Increases in preterm birth rates were not more pronounced at later gestational ages (35-36 weeks) compared to earlier ones (32-34 weeks).
- Trends in spontaneous versus non-spontaneous preterm births varied, indicating that increases were not exclusively due to induced or pre-labour caesarean sections.
Conclusions:
- Significant heterogeneity exists in preterm birth trends across European nations.
- Contrary to common belief, many European countries have stabilized or reduced singleton preterm birth rates over the study period.
- Investigating the drivers of these cross-country differences is essential for developing targeted preterm birth prevention strategies.
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